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Kumari S, Bhattacharya D, Rangaraj N, Chakarvarty S, Kondapi AK, Rao NM. Aurora kinase B siRNA-loaded lactoferrin nanoparticles potentiate the efficacy of temozolomide in treating glioblastoma. Nanomedicine (Lond) 2018; 13:2579-2596. [DOI: 10.2217/nnm-2018-0110] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Aim: To investigate the efficacy of lactoferrin nanoparticles (LfNPs) in delivering siRNA across the blood–brain barrier to treat glioblastoma multiforme (GBM) and with an additional objective of potentiation of conventional temozolomide (TMZ) chemotherapy. Methods: Aurora kinase B (AKB) siRNA-loaded nanoparticles (AKB–LfNPs) were prepared with milk protein, lactoferrin, by water in oil emulsion method. AKB–LfNPs were tested in cell lines and in GBM orthotopic mouse model with and without TMZ treatment. Results: AKB silencing, cytotoxicity and cell cycle arrest by these LfNPs were shown to be effective on GL261 cells. Tumor growth was significantly lower in AKB–LfNPs alone and in combination with TMZ treated mice and increased the survival by 2.5-times. Conclusion: Treatment of AKB–LfNPs to GBM mice improves life expectancy and has potential to combine with conventional chemotherapy.
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Affiliation(s)
- Sonali Kumari
- Department of Biotechnology & Bioinformatics, School of Life Sciences, University of Hyderabad, Prof. C. R. Rao Road, Gachibowli, Hyderabad 500 046, Telangana State, India
| | - Dwaipayan Bhattacharya
- Centre for Chemical Biology, Indian Institute of Chemical Technology (IICT), Council of Scientific & Industrial Research, Uppal Road, Hyderabad 500 007, Telangana State, India
| | - Nandini Rangaraj
- Centre for Cellular & Molecular Biology (CCMB), Council of Scientific & Industrial Research (CSIR), Uppal Road, Hyderabad 500007, Telangana State, India
| | - Sumana Chakarvarty
- Centre for Cellular & Molecular Biology (CCMB), Council of Scientific & Industrial Research (CSIR), Uppal Road, Hyderabad 500007, Telangana State, India
| | - Anand K Kondapi
- Department of Biotechnology & Bioinformatics, School of Life Sciences, University of Hyderabad, Prof. C. R. Rao Road, Gachibowli, Hyderabad 500 046, Telangana State, India
| | - Nalam M Rao
- Centre for Chemical Biology, Indian Institute of Chemical Technology (IICT), Council of Scientific & Industrial Research, Uppal Road, Hyderabad 500 007, Telangana State, India
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52
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Druzhkova TA, Yakovlev AA. Exosome Drug Delivery through the Blood–Brain Barrier: Experimental Approaches and Potential Applications. NEUROCHEM J+ 2018. [DOI: 10.1134/s1819712418030030] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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53
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Toccaceli G, Delfini R, Colonnese C, Raco A, Peschillo S. Emerging Strategies and Future Perspective in Neuro-Oncology Using Transcranial Focused Ultrasonography Technology. World Neurosurg 2018; 117:84-91. [DOI: 10.1016/j.wneu.2018.05.239] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/30/2018] [Accepted: 05/31/2018] [Indexed: 01/08/2023]
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Alli S, Figueiredo CA, Golbourn B, Sabha N, Wu MY, Bondoc A, Luck A, Coluccia D, Maslink C, Smith C, Wurdak H, Hynynen K, O'Reilly M, Rutka JT. Brainstem blood brain barrier disruption using focused ultrasound: A demonstration of feasibility and enhanced doxorubicin delivery. J Control Release 2018; 281:29-41. [PMID: 29753957 DOI: 10.1016/j.jconrel.2018.05.005] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 04/04/2018] [Accepted: 05/06/2018] [Indexed: 12/29/2022]
Abstract
Magnetic Resonance Image-guided Focused Ultrasound (MRgFUS) has been used to achieve transient blood brain barrier (BBB) opening without tissue injury. Delivery of a targeted ultrasonic wave causes an interaction between administered microbubbles and the capillary bed resulting in enhanced vessel permeability. The use of MRgFUS in the brainstem has not previously been shown but could provide value in the treatment of tumours such as Diffuse Intrinsic Pontine Glioma (DIPG) where the intact BBB has contributed to the limited success of chemotherapy. Our primary objective was to determine whether the use of MRgFUS in this eloquent brain region could be performed without histological injury and functional deficits. Our secondary objective was to select an effective chemotherapeutic against patient derived DIPG cell lines and demonstrate enhanced brainstem delivery when combined with MRgFUS in vivo. Female Sprague Dawley rats were randomised to one of four groups: 1) Microbubble administration but no MRgFUS treatment; 2) MRgFUS only; 3) MRgFUS + microbubbles; and 4) MRgFUS + microbubbles + cisplatin. Physiological assessment was performed by monitoring of heart and respiratory rates. Motor function and co-ordination were evaluated by Rotarod and grip strength testing. Histological analysis for haemorrhage (H&E), neuronal nuclei (NeuN) and apoptosis (cleaved Caspase-3) was also performed. A drug screen of eight chemotherapy agents was conducted in three patient-derived DIPG cell lines (SU-DIPG IV, SU-DIPG XIII and SU-DIPG XVII). Doxorubicin was identified as an effective agent. NOD/SCID/GAMMA (NSG) mice were subsequently administered with 5 mg/kg of intravenous doxorubicin at the time of one of the following: 1) Microbubbles but no MRgFUS; 2) MRgFUS only; 3) MRgFUS + microbubbles and 4) no intervention. Brain specimens were extracted at 2 h and doxorubicin quantification was conducted using liquid chromatography mass spectrometry (LC/MS). BBB opening was confirmed by contrast enhancement on T1-weighted MR imaging and positive Evans blue staining of the brainstem. Normal cardiorespiratory parameters were preserved. Grip strength and Rotarod testing demonstrating no decline in performance across all groups. Histological analysis showed no evidence of haemorrhage, neuronal loss or increased apoptosis. Doxorubicin demonstrated cytotoxicity against all three cell lines and is known to have poor BBB permeability. Quantities measured in the brainstem of NSG mice were highest in the group receiving MRgFUS and microbubbles (431.5 ng/g). This was significantly higher than in mice who received no intervention (7.6 ng/g). Our data demonstrates both the preservation of histological and functional integrity of the brainstem following MRgFUS for BBB opening and the ability to significantly enhance drug delivery to the region, giving promise to the treatment of brainstem-specific conditions.
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Affiliation(s)
- Saira Alli
- Division of Neurosurgery, The Arthur and Sonia Labatt Brain Tumour Research Centre, Canada; The Leeds Institute of Cancer and Pathology, University of Toronto, Canada
| | - Carlyn A Figueiredo
- Division of Neurosurgery, The Arthur and Sonia Labatt Brain Tumour Research Centre, Canada; The Division of Laboratory Medicine and Pathobiology, The Hospital for Sick Children, Canada
| | - Brian Golbourn
- The Division of Laboratory Medicine and Pathobiology, The Hospital for Sick Children, Canada
| | - Nesrin Sabha
- Program for Genetics and Genome Biology, Hospital for Sick Children, Chile
| | - Megan Yijun Wu
- The Division of Laboratory Medicine and Pathobiology, The Hospital for Sick Children, Canada
| | - Andrew Bondoc
- Division of Neurosurgery, The Arthur and Sonia Labatt Brain Tumour Research Centre, Canada
| | - Amanda Luck
- Division of Neurosurgery, The Arthur and Sonia Labatt Brain Tumour Research Centre, Canada
| | - Daniel Coluccia
- Division of Neurosurgery, The Arthur and Sonia Labatt Brain Tumour Research Centre, Canada
| | - Colin Maslink
- Division of Neurosurgery, The Arthur and Sonia Labatt Brain Tumour Research Centre, Canada
| | - Christian Smith
- Division of Neurosurgery, The Arthur and Sonia Labatt Brain Tumour Research Centre, Canada
| | - Heiko Wurdak
- The Leeds Institute of Cancer and Pathology, University of Toronto, Canada
| | - Kullervo Hynynen
- Physical Sciences Platform, Sunnybrook Research Institute, Department of Medical Biophysics, University of Toronto, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Canada
| | - Meaghan O'Reilly
- Physical Sciences Platform, Sunnybrook Research Institute, Department of Medical Biophysics, University of Toronto, Canada
| | - James T Rutka
- Division of Neurosurgery, The Arthur and Sonia Labatt Brain Tumour Research Centre, Canada; The Division of Laboratory Medicine and Pathobiology, The Hospital for Sick Children, Canada; Department of Surgery, University of Toronto, Canada.
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55
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Shen WB, Anastasiadis P, Nguyen B, Yarnell D, Yarowsky PJ, Frenkel V, Fishman PS. Magnetic Enhancement of Stem Cell-Targeted Delivery into the Brain Following MR-Guided Focused Ultrasound for Opening the Blood-Brain Barrier. Cell Transplant 2018; 26:1235-1246. [PMID: 28933214 PMCID: PMC5657739 DOI: 10.1177/0963689717715824] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Focused ultrasound (FUS)-mediated blood–brain barrier disruption (BBBD) can enable even large therapeutics such as stem cells to enter the brain from the bloodstream. However, the efficiency is relatively low. Our previous study showed that human neural progenitor cells (hNPCs) loaded with superparamagnetic iron oxide nanoparticles (SPIONs) in culture were attracted by an external magnetic field. In vivo, enhanced brain retention was observed near a magnet mounted on the skull in a rat model of traumatic brain injury, where BBBD also occurs. The goal of the current study was to determine whether magnetic attraction of SPION-loaded hNPCs would also enhance their retention in the brain after FUS-mediated BBBD. A small animal magnetic resonance imaging (MRI)-guided FUS system operating at 1.5 MHz was used to treat rats (∼120 g) without tissue damage or hemorrhage. Evidence of successful BBBD was validated with both radiologic enhancement of gadolinium on postsonication TI MRI and whole brain section visualization of Evans blue dye. The procedure was then combined with the application of a powerful magnet to the head directly after intravenous injection of the hNPCs. Validation of cells within the brain was performed by staining with Perls’ Prussian blue for iron and by immunohistochemistry with a human-specific antigen. By injecting equal numbers of iron oxide (SPIONs) and noniron oxide nanoparticles–loaded hNPCs, each labeled with a different fluorophore, we found significantly greater numbers of SPIONs-loaded cells retained in the brain at the site of BBBD as compared to noniron loaded cells. This result was most pronounced in regions of the brain closest to the skull (dorsal cortex) in proximity to the magnet surface. A more powerful magnet and a Halbach magnetic array resulted in more effective retention of SPION-labeled cells in even deeper brain regions such as the striatum and ventral cortex. There, up to 90% of hNPCs observed contained SPIONs compared to 60% to 70% with the less powerful magnet. Fewer cells were observed at 24 h posttreatment compared to 2 h (primarily in the dorsal cortex). These results demonstrate that magnetic attraction can substantially enhance the retention of stem cells after FUS-mediated BBBD. This procedure could provide a safer and less invasive approach for delivering stem cells to the brain, compared to direct intracranial injections, substantially reducing the risk of bleeding and infection.
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Affiliation(s)
- Wei-Bin Shen
- 1 Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Pavlos Anastasiadis
- 2 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ben Nguyen
- 2 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Deborah Yarnell
- 3 Neurology Service, VA Maryland Healthcare System, Baltimore, MD, USA
| | - Paul J Yarowsky
- 1 Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, USA.,4 Research Service, VA Maryland Healthcare System, Baltimore, MD, USA
| | - Victor Frenkel
- 2 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.,5 Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Paul S Fishman
- 3 Neurology Service, VA Maryland Healthcare System, Baltimore, MD, USA.,6 Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
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56
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Mathew RK, Rutka JT. Diffuse Intrinsic Pontine Glioma : Clinical Features, Molecular Genetics, and Novel Targeted Therapeutics. J Korean Neurosurg Soc 2018; 61:343-351. [PMID: 29742880 PMCID: PMC5957322 DOI: 10.3340/jkns.2018.0008] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 01/21/2018] [Indexed: 12/18/2022] Open
Abstract
Diffuse intrinsic pontine glioma (DIPG) is a deadly paediatric brain cancer. Transient response to radiation, ineffective chemotherapeutic agents and aggressive biology result in rapid progression of symptoms and a dismal prognosis. Increased availability of tumour tissue has enabled the identification of histone gene aberrations, genetic driver mutations and methylation changes, which have resulted in molecular and phenotypic subgrouping. However, many of the underlying mechanisms of DIPG oncogenesis remain unexplained. It is hoped that more representative in vitro and preclinical models–using both xenografted material and genetically engineered mice–will enable the development of novel chemotherapeutic agents and strategies for targeted drug delivery. This review provides a clinical overview of DIPG, the barriers to progress in developing effective treatment, updates on drug development and preclinical models, and an introduction to new technologies aimed at enhancing drug delivery.
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Affiliation(s)
- Ryan K Mathew
- Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Canada.,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Canada.,Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.,Department of Neurosurgery, Leeds General Infirmary, Leeds, UK
| | - James T Rutka
- Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Canada.,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Canada
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57
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Moscariello P, Ng DYW, Jansen M, Weil T, Luhmann HJ, Hedrich J. Brain Delivery of Multifunctional Dendrimer Protein Bioconjugates. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2018; 5:1700897. [PMID: 29876217 PMCID: PMC5979778 DOI: 10.1002/advs.201700897] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/21/2018] [Indexed: 05/20/2023]
Abstract
Neurological disorders are undoubtedly among the most alarming diseases humans might face. In treatment of neurological disorders, the blood-brain barrier (BBB) is a challenging obstacle preventing drug penetration into the brain. Advances in dendrimer chemistry for central nervous system (CNS) treatments are presented here. A poly(amido)amine (PAMAM) dendrimer bioconjugate with a streptavidin adapter for the attachment of dendrons or any biotinylated drug is constructed. In vitro studies on porcine or murine models and in vivo mouse studies are performed and reveal the permeation of dendronized streptavidin (DSA) into the CNS. The bioconjugate is taken up mainly by the caveolae pathway and transported across the BBB via transcytosis escaping from lysosomes. After transcytosis DSA are delivered to astrocytes and neurons. Furthermore, DSA offer high biocompatibility in vitro and in vivo. In summary, a new strategy for implementing therapeutic PAMAM function as well as drug delivery in neuropathology is presented here.
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Affiliation(s)
- Pierpaolo Moscariello
- Institute of PhysiologyUniversity Medical Center of Johannes Gutenberg University MainzDuesbergweg 6D‐55128MainzGermany
| | - David Y. W. Ng
- Max Planck Institute for Polymer ResearchAckermannweg 1055128MainzGermany
| | - Malin Jansen
- Institute of PhysiologyUniversity Medical Center of Johannes Gutenberg University MainzDuesbergweg 6D‐55128MainzGermany
| | - Tanja Weil
- Max Planck Institute for Polymer ResearchAckermannweg 1055128MainzGermany
| | - Heiko J. Luhmann
- Institute of PhysiologyUniversity Medical Center of Johannes Gutenberg University MainzDuesbergweg 6D‐55128MainzGermany
| | - Jana Hedrich
- Institute of PhysiologyUniversity Medical Center of Johannes Gutenberg University MainzDuesbergweg 6D‐55128MainzGermany
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58
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Vrettos EI, Mező G, Tzakos AG. On the design principles of peptide-drug conjugates for targeted drug delivery to the malignant tumor site. Beilstein J Org Chem 2018; 14:930-954. [PMID: 29765474 PMCID: PMC5942387 DOI: 10.3762/bjoc.14.80] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/04/2018] [Indexed: 12/30/2022] Open
Abstract
Cancer is the second leading cause of death affecting nearly one in two people, and the appearance of new cases is projected to rise by >70% by 2030. To effectively combat the menace of cancer, a variety of strategies have been exploited. Among them, the development of peptide–drug conjugates (PDCs) is considered as an inextricable part of this armamentarium and is continuously explored as a viable approach to target malignant tumors. The general architecture of PDCs consists of three building blocks: the tumor-homing peptide, the cytotoxic agent and the biodegradable connecting linker. The aim of the current review is to provide a spherical perspective on the basic principles governing PDCs, as also the methodology to construct them. We aim to offer basic and integral knowledge on the rational design towards the construction of PDCs through analyzing each building block, as also to highlight the overall progress of this rapidly growing field. Therefore, we focus on several intriguing examples from the recent literature, including important PDCs that have progressed to phase III clinical trials. Last, we address possible difficulties that may emerge during the synthesis of PDCs, as also report ways to overcome them.
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Affiliation(s)
- Eirinaios I Vrettos
- University of Ioannina, Department of Chemistry, Section of Organic Chemistry and Biochemistry, Ioannina, GR-45110, Greece
| | - Gábor Mező
- Eötvös Loránd University, Faculty of Science, Institute of Chemistry, Pázmány P. stny. 1/A, H-1117 Budapest, Hungary.,MTA-ELTE Research Group of Peptide Chemistry, Hungarian Academy of Sciences, Eötvös Loránd University, Pázmány P. stny. 1/A, H-1117 Budapest, Hungary
| | - Andreas G Tzakos
- University of Ioannina, Department of Chemistry, Section of Organic Chemistry and Biochemistry, Ioannina, GR-45110, Greece
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59
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Wang J, Garancher A, Ramaswamy V, Wechsler-Reya RJ. Medulloblastoma: From Molecular Subgroups to Molecular Targeted Therapies. Annu Rev Neurosci 2018; 41:207-232. [PMID: 29641939 DOI: 10.1146/annurev-neuro-070815-013838] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Brain tumors are the leading cause of cancer-related death in children, and medulloblastoma (MB) is the most common malignant pediatric brain tumor. Advances in surgery, radiation, and chemotherapy have improved the survival of MB patients. But despite these advances, 25-30% of patients still die from the disease, and survivors suffer severe long-term side effects from the aggressive therapies they receive. Although MB is often considered a single disease, molecular profiling has revealed a significant degree of heterogeneity, and there is a growing consensus that MB consists of multiple subgroups with distinct driver mutations, cells of origin, and prognosis. Here, we review recent progress in MB research, with a focus on the genes and pathways that drive tumorigenesis, the animal models that have been developed to study tumor biology, and the advances in conventional and targeted therapy.
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Affiliation(s)
- Jun Wang
- Tumor Initiation and Maintenance Program, NCI-Designated Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California 92037, USA;
| | - Alexandra Garancher
- Tumor Initiation and Maintenance Program, NCI-Designated Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California 92037, USA;
| | - Vijay Ramaswamy
- Division of Haematology/Oncology and Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
| | - Robert J Wechsler-Reya
- Tumor Initiation and Maintenance Program, NCI-Designated Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California 92037, USA;
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60
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Baghirov H, Snipstad S, Sulheim E, Berg S, Hansen R, Thorsen F, Mørch Y, Davies CDL, Åslund AKO. Ultrasound-mediated delivery and distribution of polymeric nanoparticles in the normal brain parenchyma of a metastatic brain tumour model. PLoS One 2018; 13:e0191102. [PMID: 29338016 PMCID: PMC5770053 DOI: 10.1371/journal.pone.0191102] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 12/28/2017] [Indexed: 01/12/2023] Open
Abstract
The treatment of brain diseases is hindered by the blood-brain barrier (BBB) preventing most drugs from entering the brain. Focused ultrasound (FUS) with microbubbles can open the BBB safely and reversibly. Systemic drug injection might induce toxicity, but encapsulation into nanoparticles reduces accumulation in normal tissue. Here we used a novel platform based on poly(2-ethyl-butyl cyanoacrylate) nanoparticle-stabilized microbubbles to permeabilize the BBB in a melanoma brain metastasis model. With a dual-frequency ultrasound transducer generating FUS at 1.1 MHz and 7.8 MHz, we opened the BBB using nanoparticle-microbubbles and low-frequency FUS, and applied high-frequency FUS to generate acoustic radiation force and push nanoparticles through the extracellular matrix. Using confocal microscopy and image analysis, we quantified nanoparticle extravasation and distribution in the brain parenchyma. We also evaluated haemorrhage, as well as the expression of P-glycoprotein, a key BBB component. FUS and microbubbles distributed nanoparticles in the brain parenchyma, and the distribution depended on the extent of BBB opening. The results from acoustic radiation force were not conclusive, but in a few animals some effect could be detected. P-glycoprotein was not significantly altered immediately after sonication. In summary, FUS with our nanoparticle-stabilized microbubbles can achieve accumulation and displacement of nanoparticles in the brain parenchyma.
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Affiliation(s)
- Habib Baghirov
- Department of Physics, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Sofie Snipstad
- Department of Physics, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Einar Sulheim
- Department of Physics, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- SINTEF Materials and Chemistry, Trondheim, Norway
| | - Sigrid Berg
- SINTEF Medical Technology, Trondheim, Norway
- Department of Circulation and Medical Imaging, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Rune Hansen
- SINTEF Medical Technology, Trondheim, Norway
- Department of Circulation and Medical Imaging, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Frits Thorsen
- Molecular Imaging Center and Kristian Gerhard Jebsen Brain Tumour Research Centre, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Yrr Mørch
- SINTEF Materials and Chemistry, Trondheim, Norway
| | - Catharina de Lange Davies
- Department of Physics, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- * E-mail:
| | - Andreas K. O. Åslund
- Department of Physics, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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61
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Jamieson JJ, Searson PC, Gerecht S. Engineering the human blood-brain barrier in vitro. J Biol Eng 2017; 11:37. [PMID: 29213304 PMCID: PMC5713119 DOI: 10.1186/s13036-017-0076-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 08/24/2017] [Indexed: 12/21/2022] Open
Abstract
The blood-brain barrier (BBB) is the interface between the vasculature and the brain, regulating molecular and cellular transport into the brain. Endothelial cells (ECs) that form the capillary walls constitute the physical barrier but are dependent on interactions with other cell types. In vitro models are widely used in BBB research for mechanistic studies and drug screening. Current models have both biological and technical limitations. Here we review recent advances in stem cell engineering that have been utilized to create innovative platforms to replicate key features of the BBB. The development of human in vitro models is envisioned to enable new mechanistic investigations of BBB transport in central nervous system diseases.
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Affiliation(s)
- John J Jamieson
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218 USA.,Institute for Nanobiotechnology, 100 Croft Hall, Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218 USA
| | - Peter C Searson
- Institute for Nanobiotechnology, 100 Croft Hall, Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218 USA.,Department of Materials Science and Engineering, Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218 USA
| | - Sharon Gerecht
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218 USA.,Institute for Nanobiotechnology, 100 Croft Hall, Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218 USA.,Department of Materials Science and Engineering, Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218 USA
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62
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Sattiraju A, Xiong X, Pandya DN, Wadas TJ, Xuan A, Sun Y, Jung Y, Sai KKS, Dorsey JF, Li KC, Mintz A. Alpha Particle Enhanced Blood Brain/Tumor Barrier Permeabilization in Glioblastomas Using Integrin Alpha-v Beta-3-Targeted Liposomes. Mol Cancer Ther 2017; 16:2191-2200. [PMID: 28619756 DOI: 10.1158/1535-7163.mct-16-0907] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 04/26/2017] [Accepted: 06/08/2017] [Indexed: 11/16/2022]
Abstract
Glioblastoma (GBM) is the most common primary malignant astrocytoma characterized by extensive invasion, angiogenesis, hypoxia, and micrometastasis. Despite the relatively leaky nature of GBM blood vessels, effective delivery of antitumor therapeutics has been a major challenge due to the complications caused by the blood-brain barrier (BBB) and the highly torturous nature of newly formed tumor vasculature (blood tumor barrier-BTB). External beam radiotherapy was previously shown to be an effective means of permeabilizing central nervous system (CNS) barriers. By using targeted short-ranged radionuclides, we show for the first time that our targeted actinium-225-labeled αvβ3-specific liposomes (225Ac-IA-TLs) caused catastrophic double stranded DNA breaks and significantly enhanced the permeability of BBB and BTB in mice bearing orthotopic GBMs. Histologic studies revealed characteristic α-particle induced double strand breaks within tumors but was not significantly present in normal brain regions away from the tumor where BBB permeability was observed. These findings indicate that the enhanced vascular permeability in these distal regions did not result from direct α-particle-induced DNA damage. On the basis of these results, in addition to their direct antitumor effects, 225Ac-IA-TLs can potentially be used to enhance the permeability of BBB and BTB for effective delivery of systemically administered antitumor therapeutics. Mol Cancer Ther; 16(10); 2191-200. ©2017 AACR.
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Affiliation(s)
- Anirudh Sattiraju
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Xiaobing Xiong
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Darpan N Pandya
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Thaddeus J Wadas
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ang Xuan
- Department of Nuclear Medicine and Radiology, the People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yao Sun
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Youngkyoo Jung
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Jay F Dorsey
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - King C Li
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Akiva Mintz
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina. .,Columbia University, New York, New York
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Hsu YH, Liu RS, Lin WL, Yuh YS, Lin SP, Wong TT. Transcranial pulsed ultrasound facilitates brain uptake of laronidase in enzyme replacement therapy for Mucopolysaccharidosis type I disease. Orphanet J Rare Dis 2017; 12:109. [PMID: 28595620 PMCID: PMC5465581 DOI: 10.1186/s13023-017-0649-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/11/2017] [Indexed: 12/31/2022] Open
Abstract
Background Mucopolysaccharidosis type I (MPS I) is a debilitating hereditary disease characterized by alpha-L-iduronidase (IDUA) deficiency and consequent inability to degrade glycosaminoglycans. The pathological accumulation of glycosaminoglycans systemically results in severe mental retardation and multiple organ dysfunction. Enzyme replacement therapy with recombinant human alpha-L-iduronidase (rhIDU) improves the function of some organs but not neurological deficits owing to its exclusion from the brain by the blood-brain barrier (BBB). Methods We divided MPS I mice into control group, enzyme replacement group with rhIDU 2.9 mg/kg injection, enzyme replacement with one-spot ultrasound treatment group, and enzyme replacement with two-spot ultrasound treatment group, and compare treatment effectiveness between groups. All ultrasound treatments were applied on left side brain. Evans blue was used to simulate the distribution of rhIDU in the brain. Results Transcranial pulsed weakly focused ultrasound combined with microbubbles facilitates brain rhIDU delivery in MPS I mice receiving systemic enzyme replacement therapy. With intravenously injected rhIDU 2.9 mg/kg, the IDUA enzyme activity on the ultrasound treated side of the cerebral hemisphere raised to 7.81-fold that on the untreated side and to 75.84% of its normal value. Evans blue simulation showed the distribution of the delivered drug was extensive, involving a large volume of the treated cerebral hemisphere. Two-spot ultrasound treatment scheme is more efficient for brain rhIDU delivery than one-spot ultrasound treatment scheme. Conclusions Transcranial pulsed weakly focused ultrasound can open BBB extensively and facilitates brain rhIDU delivery. This novel technology may provide a new MPS I treatment strategy.
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Affiliation(s)
- Yu-Hone Hsu
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei, 10617, Taiwan.,Department of Neurosurgery, Cheng-Hsin General Hospital, Taipei, Taiwan
| | - Ren-Shyan Liu
- Biomedical Imaging and Radiological Sciences, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan.,National PET/Cyclotron Center, Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Molecular and Genetic Imaging Core/Taiwan Mouse Clinic, National Comprehensive Mouse Phenotyping and Drug Testing Center, Taipei, Taiwan
| | - Win-Li Lin
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei, 10617, Taiwan.,Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli, Taiwan
| | - Yeong-Seng Yuh
- Department of Pediatrics, Cheng-Hsin General Hospital, No.45, Cheng Hsin St., Pai-Tou, Taipei, 112, Taiwan.,Department of Pediatrics, National Defense Medical Center, Taipei, Taiwan
| | - Shuan-Pei Lin
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Department of Pediatrics, MacKay Memorial Hospital, No. 92, Sec. 2 Chung-Shan North Road, Taipei, 10449, Taiwan.,Department of Medical Research, MacKay Memorial Hospital, No. 92, Sec. 2 Chung-Shan North Road, Taipei, 10449, Taiwan.,Department of Early Childhood Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Tai-Tong Wong
- Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. .,Institutes of Clinical Medicine, Taipei Medical University, Taipei, Taiwan. .,Division of Pediatric Neurosurgery, Department of Neurosurgery, Taipei Medical University Hospital, Taipei Medical University, 252 Wuxing St, Taipei, 11031, Taiwan. .,Joint Biobank, Office of Human Research, Taipei Medical University, Taipei, Taiwan.
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64
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Biological effects of blood-brain barrier disruption using a focused ultrasound. Biomed Eng Lett 2017; 7:115-120. [PMID: 30603158 DOI: 10.1007/s13534-017-0025-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/19/2017] [Accepted: 03/24/2017] [Indexed: 01/06/2023] Open
Abstract
With focused ultrasound (FUS) and microbubbles, BBB can be transiently disrupted with a localized and non-invasive approach. BBB disruption induced by FUS has made progressions to move forward on delivery of therapeutic agents into a brain in a specific area of brain for better treatment of neurological diseases. In addition to be used as an improvement of drug delivery, BBB disruption has been found to induce biological effects such as a clearance of protein aggregation which cause Alzheimer's disease, regulation of proteins which facilitate drug uptake, and modulation of neuronal function and neurogenesis. In this review, we discuss overview about the principles of BBB opening with FUS and milestones in these biological effects of FUS-induced BBB disruption.
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65
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Tosi U, Marnell CS, Chang R, Cho WC, Ting R, Maachani UB, Souweidane MM. Advances in Molecular Imaging of Locally Delivered Targeted Therapeutics for Central Nervous System Tumors. Int J Mol Sci 2017; 18:ijms18020351. [PMID: 28208698 PMCID: PMC5343886 DOI: 10.3390/ijms18020351] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 12/19/2016] [Accepted: 01/26/2017] [Indexed: 12/24/2022] Open
Abstract
Thanks to the recent advances in the development of chemotherapeutics, the morbidity and mortality of many cancers has decreased significantly. However, compared to oncology in general, the field of neuro-oncology has lagged behind. While new molecularly targeted chemotherapeutics have emerged, the impermeability of the blood–brain barrier (BBB) renders systemic delivery of these clinical agents suboptimal. To circumvent the BBB, novel routes of administration are being applied in the clinic, ranging from intra-arterial infusion and direct infusion into the target tissue (convection enhanced delivery (CED)) to the use of focused ultrasound to temporarily disrupt the BBB. However, the current system depends on a “wait-and-see” approach, whereby drug delivery is deemed successful only when a specific clinical outcome is observed. The shortcomings of this approach are evident, as a failed delivery that needs immediate refinement cannot be observed and corrected. In response to this problem, new theranostic agents, compounds with both imaging and therapeutic potential, are being developed, paving the way for improved and monitored delivery to central nervous system (CNS) malignancies. In this review, we focus on the advances and the challenges to improve early cancer detection, selection of targeted therapy, and evaluation of therapeutic efficacy, brought forth by the development of these new agents.
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Affiliation(s)
- Umberto Tosi
- Department of Neurological Surgery, Weill Cornell Medical College, New York, NY 10065, USA.
| | - Christopher S Marnell
- Department of Neurological Surgery, Weill Cornell Medical College, New York, NY 10065, USA.
| | - Raymond Chang
- Department of Neurological Surgery, Weill Cornell Medical College, New York, NY 10065, USA.
| | - William C Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China.
| | - Richard Ting
- Department of Radiology, Molecular Imaging Innovations Institute, Weill Cornell Medicine, New York, NY 10065, USA.
| | - Uday B Maachani
- Department of Neurological Surgery, Weill Cornell Medical College, New York, NY 10065, USA.
| | - Mark M Souweidane
- Department of Neurological Surgery, Weill Cornell Medical College, New York, NY 10065, USA.
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66
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Åslund AK, Snipstad S, Healey A, Kvåle S, Torp SH, Sontum PC, Davies CDL, van Wamel A. Efficient Enhancement of Blood-Brain Barrier Permeability Using Acoustic Cluster Therapy (ACT). Theranostics 2017; 7:23-30. [PMID: 28042313 PMCID: PMC5196882 DOI: 10.7150/thno.16577] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/23/2016] [Indexed: 12/27/2022] Open
Abstract
The blood-brain barrier (BBB) is a major obstacle in drug delivery for diseases of the brain, and today there is no standardized route to surpass it. One technique to locally and transiently disrupt the BBB, is focused ultrasound in combination with gas-filled microbubbles. However, the microbubbles used are typically developed for ultrasound imaging, not BBB disruption. Here we describe efficient opening of the BBB using the promising novel Acoustic Cluster Therapy (ACT), that recently has been used in combination with Abraxane® to successfully treat subcutaneous tumors of human prostate adenocarcinoma in mice. ACT is based on the conjugation of microbubbles to liquid oil microdroplets through electrostatic interactions. Upon activation in an ultrasound field, the microdroplet phase transfers to form a larger bubble that transiently lodges in the microvasculature. Further insonation induces volume oscillations of the activated bubble, which in turn induce biomechanical effects that increase the permeability of the BBB. ACT was able to safely and temporarily permeabilize the BBB, using an acoustic power 5-10 times lower than applied for conventional microbubbles, and successfully deliver small and large molecules into the brain.
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67
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Chen CC, Liu L, Ma F, Wong CW, Guo XE, Chacko JV, Farhoodi HP, Zhang SX, Zimak J, Ségaliny A, Riazifar M, Pham V, Digman MA, Pone EJ, Zhao W. Elucidation of Exosome Migration across the Blood-Brain Barrier Model In Vitro. Cell Mol Bioeng 2016; 9:509-529. [PMID: 28392840 PMCID: PMC5382965 DOI: 10.1007/s12195-016-0458-3] [Citation(s) in RCA: 338] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 06/25/2016] [Indexed: 02/07/2023] Open
Abstract
The delivery of therapeutics to the central nervous system (CNS) remains a major challenge in part due to the presence of the blood-brain barrier (BBB). Recently, cell-derived vesicles, particularly exosomes, have emerged as an attractive vehicle for targeting drugs to the brain, but whether or how they cross the BBB remains unclear. Here, we investigated the interactions between exosomes and brain microvascular endothelial cells (BMECs) in vitro under conditions that mimic the healthy and inflamed BBB in vivo. Transwell assays revealed that luciferase-carrying exosomes can cross a BMEC monolayer under stroke-like, inflamed conditions (TNF-α activated) but not under normal conditions. Confocal microscopy showed that exosomes are internalized by BMECs through endocytosis, co-localize with endosomes, in effect primarily utilizing the transcellular route of crossing. Together, these results indicate that cell-derived exosomes can cross the BBB model under stroke-like conditions in vitro. This study encourages further development of engineered exosomes as drug delivery vehicles or tracking tools for treating or monitoring neurological diseases.
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Affiliation(s)
- Claire C. Chen
- Department of Pharmaceutical Sciences, Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center and Edwards Life sciences Center for Advanced Cardiovascular Technology, 845 Health Sciences Road, University of California-Irvine, Irvine, California, 92697, USA
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
| | - Linan Liu
- Department of Pharmaceutical Sciences, Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center and Edwards Life sciences Center for Advanced Cardiovascular Technology, 845 Health Sciences Road, University of California-Irvine, Irvine, California, 92697, USA
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
| | - Fengxia Ma
- Department of Pharmaceutical Sciences, Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center and Edwards Life sciences Center for Advanced Cardiovascular Technology, 845 Health Sciences Road, University of California-Irvine, Irvine, California, 92697, USA
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China
| | - Chi W. Wong
- Department of Pharmaceutical Sciences, Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center and Edwards Life sciences Center for Advanced Cardiovascular Technology, 845 Health Sciences Road, University of California-Irvine, Irvine, California, 92697, USA
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
| | - Xuning E. Guo
- Department of Pharmaceutical Sciences, Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center and Edwards Life sciences Center for Advanced Cardiovascular Technology, 845 Health Sciences Road, University of California-Irvine, Irvine, California, 92697, USA
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
| | - Jenu V. Chacko
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
| | - Henry P. Farhoodi
- Department of Pharmaceutical Sciences, Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center and Edwards Life sciences Center for Advanced Cardiovascular Technology, 845 Health Sciences Road, University of California-Irvine, Irvine, California, 92697, USA
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
- Department of Molecular Biology & Biochemistry, University of California-Irvine, Irvine, California, 92697, USA
| | - Shirley X. Zhang
- Department of Pharmaceutical Sciences, Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center and Edwards Life sciences Center for Advanced Cardiovascular Technology, 845 Health Sciences Road, University of California-Irvine, Irvine, California, 92697, USA
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
| | - Jan Zimak
- Department of Pharmaceutical Sciences, Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center and Edwards Life sciences Center for Advanced Cardiovascular Technology, 845 Health Sciences Road, University of California-Irvine, Irvine, California, 92697, USA
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
| | - Aude Ségaliny
- Department of Pharmaceutical Sciences, Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center and Edwards Life sciences Center for Advanced Cardiovascular Technology, 845 Health Sciences Road, University of California-Irvine, Irvine, California, 92697, USA
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
| | - Milad Riazifar
- Department of Pharmaceutical Sciences, Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center and Edwards Life sciences Center for Advanced Cardiovascular Technology, 845 Health Sciences Road, University of California-Irvine, Irvine, California, 92697, USA
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
| | - Victor Pham
- Department of Pharmaceutical Sciences, Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center and Edwards Life sciences Center for Advanced Cardiovascular Technology, 845 Health Sciences Road, University of California-Irvine, Irvine, California, 92697, USA
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
| | - Michelle A. Digman
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
- Laboratory for Fluorescence Dynamics, University of California-Irvine, California 92697, USA
- Centre for Bioactive Discovery in Health and Ageing, School of Science and Technology, University of New England, Armidale, New South Wales 2351, Australia
| | - Egest J. Pone
- Department of Pharmaceutical Sciences, Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center and Edwards Life sciences Center for Advanced Cardiovascular Technology, 845 Health Sciences Road, University of California-Irvine, Irvine, California, 92697, USA
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
| | - Weian Zhao
- Department of Pharmaceutical Sciences, Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center and Edwards Life sciences Center for Advanced Cardiovascular Technology, 845 Health Sciences Road, University of California-Irvine, Irvine, California, 92697, USA
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, 92697, USA
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Mangraviti A, Gullotti D, Tyler B, Brem H. Nanobiotechnology-based delivery strategies: New frontiers in brain tumor targeted therapies. J Control Release 2016; 240:443-453. [DOI: 10.1016/j.jconrel.2016.03.031] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 02/05/2016] [Accepted: 03/18/2016] [Indexed: 02/06/2023]
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Mano Y, Saito R, Haga Y, Matsunaga T, Zhang R, Chonan M, Haryu S, Shoji T, Sato A, Sonoda Y, Tsuruoka N, Nishiyachi K, Sumiyoshi A, Nonaka H, Kawashima R, Tominaga T. Intraparenchymal ultrasound application and improved distribution of infusate with convection-enhanced delivery in rodent and nonhuman primate brain. J Neurosurg 2016; 124:1490-500. [DOI: 10.3171/2015.3.jns142152] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECT
Convection-enhanced delivery (CED) is an effective drug delivery method that delivers high concentrations of drugs directly into the targeted lesion beyond the blood-brain barrier. However, the drug distribution attained using CED has not satisfactorily covered the entire targeted lesion in tumors such as glioma. Recently, the efficacy of ultrasound assistance was reported for various drug delivery applications. The authors developed a new ultrasound-facilitated drug delivery (UFD) system that enables the application of ultrasound at the infusion site. The purpose of this study was to demonstrate the efficacy of the UFD system and to examine effective ultrasound profiles.
METHODS
The authors fabricated a steel bar-based device that generates ultrasound and enables infusion of the aqueous drug from one end of the bar. The volume of distribution (Vd) after infusion of 10 ml of 2% Evans blue dye (EBD) into rodent brain was tested with different frequencies and applied voltages: 252 kHz/30 V; 252 kHz/60 V; 524 kHz/13 V; 524 kHz/30 V; and 524 kHz/60 V. In addition, infusion of 5 mM gadopentetate dimeglumine (Gd-DTPA) was tested with 260 kHz/60 V, the distribution of which was evaluated using a 7-T MRI unit. In a nonhuman primate (Macaca fascicularis) study, 300 μl of 1 mM Gd-DTPA/EBD was infused. The final distribution was evaluated using MRI. Two-sample comparisons were made by Student t-test, and 1-way ANOVA was used for multiple comparisons. Significance was set at p < 0.05.
RESULTS
After infusion of 10 μl of EBD into the rat brain using the UFD system, the Vds of EBD in the UFD groups were significantly larger than those of the control group. When a frequency of 252 kHz was applied, the Vd of the group in which 60 V was applied was significantly larger than that of the group in which 30 V was used. When a frequency of 524 kHz was applied, the Vd tended to increase with application of a higher voltage; however, the differences were not significant (1-way ANOVA). The Vd of Gd-DTPA was also significantly larger in the UFD group than in the control group (p < 0.05, Student t-test). The volume of Gd-DTPA in the nonhuman primate used in this study was 1209.8 ± 193.6 mm3. This volume was much larger than that achieved by conventional CED (568.6 ± 141.0 mm3).
CONCLUSIONS
The UFD system facilitated the distribution of EBD and Gd-DTPA more effectively than conventional CED. Lower frequency and higher applied voltage using resonance frequencies might be more effective to enlarge the Vd. The UFD system may provide a new treatment approach for CNS disorders.
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Affiliation(s)
- Yui Mano
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Ryuta Saito
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Yoichi Haga
- 2Department of Biomedical Engineering, Tohoku University Graduate School of Biomedical Engineering
| | - Tadao Matsunaga
- 3Tohoku University Micro System Integration Center (μSIC); and
| | - Rong Zhang
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Masashi Chonan
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Shinya Haryu
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Takuhiro Shoji
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Aya Sato
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Yukihiko Sonoda
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Noriko Tsuruoka
- 2Department of Biomedical Engineering, Tohoku University Graduate School of Biomedical Engineering
| | - Keisuke Nishiyachi
- 2Department of Biomedical Engineering, Tohoku University Graduate School of Biomedical Engineering
| | - Akira Sumiyoshi
- 4Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Hiroi Nonaka
- 4Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Ryuta Kawashima
- 4Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Teiji Tominaga
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
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70
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Glioma-targeted therapy using Cilengitide nanoparticles combined with UTMD enhanced delivery. J Control Release 2016; 224:112-125. [DOI: 10.1016/j.jconrel.2016.01.015] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 12/10/2015] [Accepted: 01/08/2016] [Indexed: 12/14/2022]
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Copelan A, Hartman J, Chehab M, Venkatesan AM. High-Intensity Focused Ultrasound: Current Status for Image-Guided Therapy. Semin Intervent Radiol 2015; 32:398-415. [PMID: 26622104 DOI: 10.1055/s-0035-1564793] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Image-guided high-intensity focused ultrasound (HIFU) is an innovative therapeutic technology, permitting extracorporeal or endocavitary delivery of targeted thermal ablation while minimizing injury to the surrounding structures. While ultrasound-guided HIFU was the original image-guided system, MR-guided HIFU has many inherent advantages, including superior depiction of anatomic detail and superb real-time thermometry during thermoablation sessions, and it has recently demonstrated promising results in the treatment of both benign and malignant tumors. HIFU has been employed in the management of prostate cancer, hepatocellular carcinoma, uterine leiomyomas, and breast tumors, and has been associated with success in limited studies for palliative pain management in pancreatic cancer and bone tumors. Nonthermal HIFU bioeffects, including immune system modulation and targeted drug/gene therapy, are currently being explored in the preclinical realm, with an emphasis on leveraging these therapeutic effects in the care of the oncology patient. Although still in its early stages, the wide spectrum of therapeutic capabilities of HIFU offers great potential in the field of image-guided oncologic therapy.
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Affiliation(s)
- Alexander Copelan
- Department of Diagnostic Radiology, William Beaumont Hospital, Royal Oak, Michigan
| | - Jason Hartman
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Monzer Chehab
- Department of Diagnostic Radiology, William Beaumont Hospital, Royal Oak, Michigan
| | - Aradhana M Venkatesan
- Section of Abdominal Imaging, Department of Diagnostic Radiology, MD Anderson Cancer Center, Houston, Texas
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Peschillo S, Caporlingua A, Diana F, Caporlingua F, Delfini R. New therapeutic strategies regarding endovascular treatment of glioblastoma, the role of the blood-brain barrier and new ways to bypass it. J Neurointerv Surg 2015; 8:1078-82. [PMID: 26541791 DOI: 10.1136/neurintsurg-2015-012048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 10/12/2015] [Indexed: 12/12/2022]
Abstract
The treatment protocols for glioblastoma multiforme (GBM) involve a combination of surgery, radiotherapy and adjuvant chemotherapy. Despite this multimodal approach, the prognosis of patients with GBM remains poor and there is an urgent need to develop novel strategies to improve quality of life and survival in this population. In an effort to improve outcomes, intra-arterial drug delivery has been used in many recent clinical trials; however, their results have been conflicting. The blood-brain barrier (BBB) is the major obstacle preventing adequate concentrations of chemotherapy agents being reached in tumor tissue, regardless of the method of delivering the drugs. Therapeutic failures have often been attributed to an inability of drugs to cross the BBB. However, during the last decade, a better understanding of BBB physiology along with the development of new technologies has led to innovative methods to circumvent this barrier. This paper focuses on strategies and techniques used to bypass the BBB already tested in clinical trials in humans and also those in their preclinical stage. We also discuss future therapeutic scenarios, including endovascular treatment combined with BBB disruption techniques, for patients with GBM.
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Affiliation(s)
- S Peschillo
- Department of Neurology and Psychiatry, Endovascular Neurosurgery/Interventional Neuroradiology, 'Sapienza' University of Rome, Rome, Italy
| | - A Caporlingua
- Department of Neurology and Psychiatry, Neurosurgery, 'Sapienza' University of Rome, Rome, Italy
| | - F Diana
- Department of Radiology, 'Sapienza' University of Rome, Rome, Italy
| | - F Caporlingua
- Department of Neurology and Psychiatry, Neurosurgery, 'Sapienza' University of Rome, Rome, Italy
| | - R Delfini
- Department of Neurology and Psychiatry, Neurosurgery, 'Sapienza' University of Rome, Rome, Italy
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Oberoi RK, Parrish KE, Sio TT, Mittapalli RK, Elmquist WF, Sarkaria JN. Strategies to improve delivery of anticancer drugs across the blood-brain barrier to treat glioblastoma. Neuro Oncol 2015; 18:27-36. [PMID: 26359209 DOI: 10.1093/neuonc/nov164] [Citation(s) in RCA: 183] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 07/15/2015] [Indexed: 12/21/2022] Open
Abstract
Glioblastoma (GBM) is a lethal and aggressive brain tumor that is resistant to conventional radiation and cytotoxic chemotherapies. Molecularly targeted agents hold great promise in treating these genetically heterogeneous tumors, yet have produced disappointing results. One reason for the clinical failure of these novel therapies can be the inability of the drugs to achieve effective concentrations in the invasive regions beyond the bulk tumor. In this review, we describe the influence of the blood-brain barrier on the distribution of anticancer drugs to both the tumor core and infiltrative regions of GBM. We further describe potential strategies to overcome these drug delivery limitations. Understanding the key factors that limit drug delivery into brain tumors will guide future development of approaches for enhanced delivery of effective drugs to GBM.
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Affiliation(s)
- Rajneet K Oberoi
- Department of Pharmaceutics, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota (R.K.O., K.E.P., R.K.M., W.F.E.); Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (T.T.S., J.N.S.)
| | - Karen E Parrish
- Department of Pharmaceutics, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota (R.K.O., K.E.P., R.K.M., W.F.E.); Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (T.T.S., J.N.S.)
| | - Terence T Sio
- Department of Pharmaceutics, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota (R.K.O., K.E.P., R.K.M., W.F.E.); Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (T.T.S., J.N.S.)
| | - Rajendar K Mittapalli
- Department of Pharmaceutics, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota (R.K.O., K.E.P., R.K.M., W.F.E.); Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (T.T.S., J.N.S.)
| | - William F Elmquist
- Department of Pharmaceutics, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota (R.K.O., K.E.P., R.K.M., W.F.E.); Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (T.T.S., J.N.S.)
| | - Jann N Sarkaria
- Department of Pharmaceutics, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota (R.K.O., K.E.P., R.K.M., W.F.E.); Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (T.T.S., J.N.S.)
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Xiong X, Sun Y, Sattiraju A, Jung Y, Mintz A, Hayasaka S, Li KCP. Remote spatiotemporally controlled and biologically selective permeabilization of blood-brain barrier. J Control Release 2015; 217:113-20. [PMID: 26334482 DOI: 10.1016/j.jconrel.2015.08.044] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 08/19/2015] [Accepted: 08/24/2015] [Indexed: 12/13/2022]
Abstract
The blood-brain barrier (BBB), comprised of brain endothelial cells with tight junctions (TJ) between them, regulates the extravasation of molecules and cells into and out of the central nervous system (CNS). Overcoming the difficulty of delivering therapeutic agents to specific regions of the brain presents a major challenge to treatment of a broad range of brain disorders. Current strategies for BBB opening are invasive, not specific, and lack precise control over the site and timing of BBB opening, which may limit their clinical translation. In the present report, we describe a novel approach based on a combination of stem cell delivery, heat-inducible gene expression and mild heating with high-intensity focused ultrasound (HIFU) under MRI guidance to remotely permeabilize BBB. The permeabilization of the BBB will be controlled with, and limited to where selected pro-inflammatory factors will be secreted secondary to HIFU activation, which is in the vicinity of the engineered stem cells and consequently both the primary and secondary disease foci. This therapeutic platform thus represents a non-invasive way for BBB opening with unprecedented spatiotemporal precision, and if properly and specifically modified, can be clinically translated to facilitate delivery of different diagnostic and therapeutic agents which can have great impact in treatment of various disease processes in the central nervous system.
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Affiliation(s)
- Xiaobing Xiong
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem 27157, USA
| | - Yao Sun
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem 27157, USA
| | - Anirudh Sattiraju
- Comprehensive Cancer Center, Brain Tumor Center of Excellence, Wake Forest School of Medicine, Winston-Salem 27157, USA
| | - Youngkyoo Jung
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem 27157, USA; Comprehensive Cancer Center, Brain Tumor Center of Excellence, Wake Forest School of Medicine, Winston-Salem 27157, USA; Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem 27157, USA
| | - Akiva Mintz
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem 27157, USA; Comprehensive Cancer Center, Brain Tumor Center of Excellence, Wake Forest School of Medicine, Winston-Salem 27157, USA
| | - Satoru Hayasaka
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem 27157, USA; Department of Biostatistics Sciences, Wake Forest School of Medicine, Winston-Salem 27157, USA
| | - King C P Li
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem 27157, USA.
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75
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Park JB, Agnihotri S, Golbourn B, Bertrand KC, Luck A, Sabha N, Smith CA, Byron S, Zadeh G, Croul S, Berens M, Rutka JT. Transcriptional profiling of GBM invasion genes identifies effective inhibitors of the LIM kinase-Cofilin pathway. Oncotarget 2015; 5:9382-95. [PMID: 25237832 PMCID: PMC4253441 DOI: 10.18632/oncotarget.2412] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Malignant gliomas are highly proliferative and invasive neoplasms where total surgical resection is often impossible and effective local radiation therapy difficult. Consequently, there is a need to develop a greater understanding of the molecular events driving invasion and to identify novel treatment targets. Using microarray analysis comparing normal brain samples and mesenchymal glioblastoma multiforme (GBM), we identified over 140 significant genes involved in cell migration and invasion. The cofilin (CFL) pathway, which disassembles actin filaments, was highly up-regulated compared to normal brain. Up-regulation of LIM domain kinase 1 and 2 (LIMK1/2), that phosphorylates and inactivates cofilin, was confirmed in an additional independent data set comparing normal brain to GBM. We identified and utilized two small molecule inhibitors BMS-5 and Cucurbitacin I directed against the cofilin regulating kinases, LIMK1 and LIMK2, to target this pathway. Significant decreases in cell viability were observed in glioma cells treated with BMS-5 and Cucurbitacin I, while no cytotoxic effects were seen in normal astrocytes that lack LIMK. BMS-5 and Cucurbitacin I promoted increased adhesion in GBM cells, and decreased migration and invasion. Collectively, these data suggest that use of LIMK inhibitors may provide a novel way to target the invasive machinery in GBM.
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Affiliation(s)
- Jun-Bum Park
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada. Department of Neurological Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Sameer Agnihotri
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Brian Golbourn
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Kelsey C Bertrand
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Amanda Luck
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Nesrin Sabha
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Christian A Smith
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Sara Byron
- Cancer and Cell Biology Division, Translational Genomics Research Institute, Phoenix, Arizona, United States of America
| | - Gelareh Zadeh
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada. Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Canada
| | - Sidney Croul
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Michael Berens
- Cancer and Cell Biology Division, Translational Genomics Research Institute, Phoenix, Arizona, United States of America
| | - James T Rutka
- Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, ON, Canada. Department of Surgery, University of Toronto, Toronto ON, Canada
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76
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Man K, Sabourin VM, Gandhi CD, Carmel PW, Prestigiacomo CJ. Pierre Curie: the anonymous neurosurgical contributor. Neurosurg Focus 2015; 39:E7. [PMID: 26126406 DOI: 10.3171/2015.4.focus15102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Pierre Curie, best known as a Nobel Laureate in Physics for his co-contributions to the field of radioactivity alongside research partner and wife Marie Curie, died suddenly in 1906 from a street accident in Paris. Tragically, his skull was crushed under the wheel of a horse-drawn carriage. This article attempts to honor the life and achievements of Pierre Curie, whose trailblazing work in radioactivity and piezoelectricity set into motion a wide range of technological developments that have culminated in the advent of numerous techniques used in neurological surgery today. These innovations include brachytherapy, Gamma Knife radiosurgery, focused ultrasound, and haptic feedback in robotic surgery.
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Affiliation(s)
- Karen Man
- Departments of 1 Neurological Surgery
| | | | - Chirag D Gandhi
- Departments of 1 Neurological Surgery.,Radiology.,Neurology and Neuroscience, Rutgers New Jersey Medical School, Newark, New Jersey
| | | | - Charles J Prestigiacomo
- Departments of 1 Neurological Surgery.,Radiology.,Neurology and Neuroscience, Rutgers New Jersey Medical School, Newark, New Jersey
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77
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Ghanouni P, Pauly KB, Elias WJ, Henderson J, Sheehan J, Monteith S, Wintermark M. Transcranial MRI-Guided Focused Ultrasound: A Review of the Technologic and Neurologic Applications. AJR Am J Roentgenol 2015; 205:150-9. [PMID: 26102394 PMCID: PMC4687492 DOI: 10.2214/ajr.14.13632] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This article reviews the physical principles of MRI-guided focused ultra-sound and discusses current and potential applications of this exciting technology. CONCLUSION MRI-guided focused ultrasound is a new minimally invasive method of targeted tissue thermal ablation that may be of use to treat central neuropathic pain, essential tremor, Parkinson tremor, and brain tumors. The system has also been used to temporarily disrupt the blood-brain barrier to allow targeted drug delivery to brain tumors.
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Affiliation(s)
- Pejman Ghanouni
- Stanford University, Department of Radiology, Division of Body MRI, Stanford, CA
| | - Kim Butts Pauly
- Stanford University, Departments of Radiology and Electrical Engineering and Bioengineering, Stanford, CA
| | - W. Jeff Elias
- University of Virginia, Department of Neurosurgery, Charlottesville, VA
| | - Jaimie Henderson
- Stanford University, Department of Neurosurgery and Neurology and Neurological Sciences, Stanford, CA
| | - Jason Sheehan
- University of Virginia, Department of Neurosurgery, Charlottesville, VA
| | | | - Max Wintermark
- Stanford University, Department of Radiology, Division of Neuroradiology, Stanford, CA
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78
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Hargrave D. Pediatric diffuse intrinsic pontine glioma: can optimism replace pessimism? CNS Oncol 2015; 1:137-48. [PMID: 25057864 DOI: 10.2217/cns.12.15] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Pediatric diffuse intrinsic pontine glioma (DIPG) has a dismal prognosis that has not seen a change in outcome despite multiple clinical trials. Possible reasons for failure to make progress in this aggressive childhood brain tumor include: poor understanding of the underlying molecular biology due to lack of access to tumor material; absence of accurate and relevant DIPG preclinical models for drug development; ill-defined therapeutic targets for novel agents; and inadequate drug delivery to the brainstem. This review will demonstrate that systematic studies to identify solutions for each of these barriers is starting to deliver progress that can turn pessimism to optimism in DIPG.
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Affiliation(s)
- Darren Hargrave
- Department of Pediatric Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK.
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79
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Rutka JT, Kim B, Etame A, Diaz RJ. Nanosurgical resection of malignant brain tumors: beyond the cutting edge. ACS NANO 2014; 8:9716-9722. [PMID: 25233362 DOI: 10.1021/nn504854a] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Advances in surgical procedures and improvements in patient outcomes have resulted from applications of new technologies in the operating room over the past three decades. All surgeons would be excited about the possibilities of improving their resections of tumors for patients with cancer if a new technology were introduced to facilitate this. In this issue of ACS Nano, Karabeber et al. use a hand-held Raman scanner to probe the completeness of resection of glioblastoma multiforme (GBM), the most malignant brain cancer, in a genetically engineered mouse model. They show that the hand-held scanner could accurately detect gold-silica surface-enhanced Raman scattering nanoparticles embedded within the GBM, resulting in a complete tumor resection. In this Perspective, we review potential applications of nanotechnologies to neurosurgery and describe how new systems, such as the one described in this issue, may be brought closer to the operating room through modifications in nanoparticle size, overcoming the obstacles presented by the blood-brain barrier, and functionalizing nanoparticle conjugates so that they reach their target at highest concentrations possible. Finally, with adaptations of the actual hand-held Raman scanner device itself, one can envision the day when "nanosurgical" procedures will be a part of the surgeon's armamentarium.
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Affiliation(s)
- James T Rutka
- Division of Neurosurgery, Department of Surgery, and the Arthur and Sonia Labatt Brain Tumour Research Centre, University of Toronto , Toronto, Canada M5G 1X8
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80
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Padayachy LC, Fieggen G. Intraoperative Ultrasound-Guidance in Neurosurgery. World Neurosurg 2014; 82:e409-11. [DOI: 10.1016/j.wneu.2013.09.052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 09/30/2013] [Indexed: 11/25/2022]
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81
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Transendothelial Transport and Its Role in Therapeutics. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:309404. [PMID: 27355037 PMCID: PMC4897564 DOI: 10.1155/2014/309404] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 06/13/2014] [Accepted: 06/18/2014] [Indexed: 12/17/2022]
Abstract
Present review paper highlights role of BBB in endothelial transport of various substances into the brain. More specifically, permeability functions of BBB in transendothelial transport of various substances such as metabolic fuels, ethanol, amino acids, proteins, peptides, lipids, vitamins, neurotransmitters, monocarbxylic acids, gases, water, and minerals in the peripheral circulation and into the brain have been widely explained. In addition, roles of various receptors, ATP powered pumps, channels, and transporters in transport of vital molecules in maintenance of homeostasis and normal body functions have been described in detail. Major role of integral membrane proteins, carriers, or transporters in drug transport is highlighted. Both diffusion and carrier mediated transport mechanisms which facilitate molecular trafficking through transcellular route to maintain influx and outflux of important nutrients and metabolic substances are elucidated. Present review paper aims to emphasize role of important transport systems with their recent advancements in CNS protection mainly for providing a rapid clinical aid to patients. This review also suggests requirement of new well-designed therapeutic strategies mainly potential techniques, appropriate drug formulations, and new transport systems for quick, easy, and safe delivery of drugs across blood brain barrier to save the life of tumor and virus infected patients.
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82
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Upadhyay RK. Drug delivery systems, CNS protection, and the blood brain barrier. BIOMED RESEARCH INTERNATIONAL 2014; 2014:869269. [PMID: 25136634 PMCID: PMC4127280 DOI: 10.1155/2014/869269] [Citation(s) in RCA: 211] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 05/31/2014] [Accepted: 06/05/2014] [Indexed: 12/12/2022]
Abstract
Present review highlights various drug delivery systems used for delivery of pharmaceutical agents mainly antibiotics, antineoplastic agents, neuropeptides, and other therapeutic substances through the endothelial capillaries (BBB) for CNS therapeutics. In addition, the use of ultrasound in delivery of therapeutic agents/biomolecules such as proline rich peptides, prodrugs, radiopharmaceuticals, proteins, immunoglobulins, and chimeric peptides to the target sites in deep tissue locations inside tumor sites of brain has been explained. In addition, therapeutic applications of various types of nanoparticles such as chitosan based nanomers, dendrimers, carbon nanotubes, niosomes, beta cyclodextrin carriers, cholesterol mediated cationic solid lipid nanoparticles, colloidal drug carriers, liposomes, and micelles have been discussed with their recent advancements. Emphasis has been given on the need of physiological and therapeutic optimization of existing drug delivery methods and their carriers to deliver therapeutic amount of drug into the brain for treatment of various neurological diseases and disorders. Further, strong recommendations are being made to develop nanosized drug carriers/vehicles and noninvasive therapeutic alternatives of conventional methods for better therapeutics of CNS related diseases. Hence, there is an urgent need to design nontoxic biocompatible drugs and develop noninvasive delivery methods to check posttreatment clinical fatalities in neuropatients which occur due to existing highly toxic invasive drugs and treatment methods.
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Affiliation(s)
- Ravi Kant Upadhyay
- Department of Zoology, DDU Gorakhpur University, Gorakhpur 273009, India
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83
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Abstract
While traditional computed tomography (CT) and magnetic resonance (MR) imaging illustrate the structural morphology of brain pathology, newer, dynamic imaging techniques are able to show the movement of contrast throughout the brain parenchyma and across the blood-brain barrier (BBB). These data, in combination with pharmacokinetic models, can be used to investigate BBB permeability, which has wide-ranging applications in the diagnosis and management of central nervous system (CNS) tumors in children. In the first part of this paper, we review the technical principles underlying four imaging modalities used to evaluate BBB permeability: PET, dynamic CT, dynamic T1-weighted contrast-enhanced MR imaging, and dynamic T2-weighted susceptibility contrast MR. We describe the data that can be derived from each method, provide some caveats to data interpretation, and compare the advantages and disadvantages of the different techniques. In the second part of this paper, we review the clinical applications that have been reported with permeability imaging data, including diagnosing the nature of a lesion found on imaging (neoplastic versus non-neoplastic, tumor type, tumor grade, recurrence versus pseudoprogression), predicting the natural history of a tumor, monitoring angiogenesis and tracking response to anti-angiogenic agents, optimizing chemotherapy agent selection, and aiding in the development of new antineoplastic drugs and methods to increase local delivery of chemotherapeutics.
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Affiliation(s)
- Sandi Lam
- 1 Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA ; 2 Functional and Stereotactic Neurosurgery, Department of Surgery, University of Chicago, Chicago, Illinois, USA
| | - Yimo Lin
- 1 Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA ; 2 Functional and Stereotactic Neurosurgery, Department of Surgery, University of Chicago, Chicago, Illinois, USA
| | - Peter C Warnke
- 1 Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA ; 2 Functional and Stereotactic Neurosurgery, Department of Surgery, University of Chicago, Chicago, Illinois, USA
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84
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Christian E, Yu C, Apuzzo MLJ. Focused ultrasound: relevant history and prospects for the addition of mechanical energy to the neurosurgical armamentarium. World Neurosurg 2014; 82:354-65. [PMID: 24952224 DOI: 10.1016/j.wneu.2014.06.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 06/08/2014] [Accepted: 06/10/2014] [Indexed: 10/25/2022]
Abstract
Although the concept of focused ultrasonography emerged more than 70 years ago, the need for a craniectomy obviated its development as a noninvasive technology. Since then advances in phased array transducers and magnetic resonance imaging technology have resurrected the ultrasound as a noninvasive therapeutic for a plethora of neurological conditions ranging from embolic stroke and intracranial hemorrhage to movement disorders and brain neoplasia. In the same way that stereotactic radiosurgery has fundamentally changed the scope and treatment paradigms of tumor and specifically skull base surgery, focused ultrasound has a similar potential to revolutionize the field of neurological surgery. In addition, focused ultrasound comes without the general complexity or the risks of ionizing radiation that accompany radiosurgery. As the quest for minimally invasive and noninvasive therapeutics continues to define the new neurosurgery, the focused ultrasound evolves to join the neurosurgical armamentarium.
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Affiliation(s)
- Eisha Christian
- Department of Neurosurgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Cheng Yu
- Department of Neurosurgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA.
| | - Michael L J Apuzzo
- Department of Neurosurgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
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85
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Ultrasound-guided tissue fractionation by high intensity focused ultrasound in an in vivo porcine liver model. Proc Natl Acad Sci U S A 2014; 111:8161-6. [PMID: 24843132 DOI: 10.1073/pnas.1318355111] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The clinical use of high intensity focused ultrasound (HIFU) therapy for noninvasive tissue ablation has been recently gaining momentum. In HIFU, ultrasound energy from an extracorporeal source is focused within the body to ablate tissue at the focus while leaving the surrounding organs and tissues unaffected. Most HIFU therapies are designed to use heating effects resulting from the absorption of ultrasound by tissue to create a thermally coagulated treatment volume. Although this approach is often successful, it has its limitations, such as the heat sink effect caused by the presence of a large blood vessel near the treatment area or heating of the ribs in the transcostal applications. HIFU-induced bubbles provide an alternative means to destroy the target tissue by mechanical disruption or, at its extreme, local fractionation of tissue within the focal region. Here, we demonstrate the feasibility of a recently developed approach to HIFU-induced ultrasound-guided tissue fractionation in an in vivo pig model. In this approach, termed boiling histotripsy, a millimeter-sized boiling bubble is generated by ultrasound and further interacts with the ultrasound field to fractionate porcine liver tissue into subcellular debris without inducing further thermal effects. Tissue selectivity, demonstrated by boiling histotripsy, allows for the treatment of tissue immediately adjacent to major blood vessels and other connective tissue structures. Furthermore, boiling histotripsy would benefit the clinical applications, in which it is important to accelerate resorption or passage of the ablated tissue volume, diminish pressure on the surrounding organs that causes discomfort, or insert openings between tissues.
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86
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Pulkkinen A, Werner B, Martin E, Hynynen K. Numerical simulations of clinical focused ultrasound functional neurosurgery. Phys Med Biol 2014; 59:1679-700. [PMID: 24619067 DOI: 10.1088/0031-9155/59/7/1679] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A computational model utilizing grid and finite difference methods were developed to simulate focused ultrasound functional neurosurgery interventions. The model couples the propagation of ultrasound in fluids (soft tissues) and solids (skull) with acoustic and visco-elastic wave equations. The computational model was applied to simulate clinical focused ultrasound functional neurosurgery treatments performed in patients suffering from therapy resistant chronic neuropathic pain. Datasets of five patients were used to derive the treatment geometry. Eight sonications performed in the treatments were then simulated with the developed model. Computations were performed by driving the simulated phased array ultrasound transducer with the acoustic parameters used in the treatments. Resulting focal temperatures and size of the thermal foci were compared quantitatively, in addition to qualitative inspection of the simulated pressure and temperature fields. This study found that the computational model and the simulation parameters predicted an average of 24 ± 13% lower focal temperature elevations than observed in the treatments. The size of the simulated thermal focus was found to be 40 ± 13% smaller in the anterior-posterior direction and 22 ± 14% smaller in the inferior-superior direction than in the treatments. The location of the simulated thermal focus was off from the prescribed target by 0.3 ± 0.1 mm, while the peak focal temperature elevation observed in the measurements was off by 1.6 ± 0.6 mm. Although the results of the simulations suggest that there could be some inaccuracies in either the tissue parameters used, or in the simulation methods, the simulations were able to predict the focal spot locations and temperature elevations adequately for initial treatment planning performed to assess, for example, the feasibility of sonication. The accuracy of the simulations could be improved if more precise ultrasound tissue properties (especially of the skull bone) could be obtained.
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Affiliation(s)
- Aki Pulkkinen
- University of Eastern Finland, Kuopio Campus, PO Box 1627, FI-70211 Kuopio, Finland
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87
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Cheng Y, Morshed RA, Auffinger B, Tobias AL, Lesniak MS. Multifunctional nanoparticles for brain tumor imaging and therapy. Adv Drug Deliv Rev 2014; 66:42-57. [PMID: 24060923 PMCID: PMC3948347 DOI: 10.1016/j.addr.2013.09.006] [Citation(s) in RCA: 230] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 08/28/2013] [Accepted: 09/13/2013] [Indexed: 12/16/2022]
Abstract
Brain tumors are a diverse group of neoplasms that often carry a poor prognosis for patients. Despite tremendous efforts to develop diagnostic tools and therapeutic avenues, the treatment of brain tumors remains a formidable challenge in the field of neuro-oncology. Physiological barriers including the blood-brain barrier result in insufficient accumulation of therapeutic agents at the site of a tumor, preventing adequate destruction of malignant cells. Furthermore, there is a need for improvements in brain tumor imaging to allow for better characterization and delineation of tumors, visualization of malignant tissue during surgery, and tracking of response to chemotherapy and radiotherapy. Multifunctional nanoparticles offer the potential to improve upon many of these issues and may lead to breakthroughs in brain tumor management. In this review, we discuss the diagnostic and therapeutic applications of nanoparticles for brain tumors with an emphasis on innovative approaches in tumor targeting, tumor imaging, and therapeutic agent delivery. Clinically feasible nanoparticle administration strategies for brain tumor patients are also examined. Furthermore, we address the barriers towards clinical implementation of multifunctional nanoparticles in the context of brain tumor management.
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Affiliation(s)
- Yu Cheng
- The Brain Tumor Center, The University of Chicago, Chicago, IL, USA
| | - Ramin A Morshed
- The Brain Tumor Center, The University of Chicago, Chicago, IL, USA
| | - Brenda Auffinger
- The Brain Tumor Center, The University of Chicago, Chicago, IL, USA
| | - Alex L Tobias
- The Brain Tumor Center, The University of Chicago, Chicago, IL, USA
| | - Maciej S Lesniak
- The Brain Tumor Center, The University of Chicago, Chicago, IL, USA.
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88
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Di Paolo A, Gori G, Tascini C, Danesi R, Del Tacca M. Clinical pharmacokinetics of antibacterials in cerebrospinal fluid. Clin Pharmacokinet 2014; 52:511-42. [PMID: 23605634 DOI: 10.1007/s40262-013-0062-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
In the past 20 years, an increased discrepancy between new available antibacterials and the emergence of multidrug-resistant strains has been observed. This condition concerns physicians involved in the treatment of central nervous system (CNS) infections, for which clinical and microbiological success depends on the rapid achievement of bactericidal concentrations. In order to accomplish this aim, the choice of drugs is based on their disposition toward the cerebrospinal fluid (CSF), which is influenced by the physicochemical characteristics of antibacterials. A reduced distribution into CSF has been documented for beta-lactams, especially cephalosporins and carbapenems, on the basis of their hydrophilic nature. However, they represent a cornerstone of the majority of combined therapeutic schemes for their ability to achieve bactericidal concentrations, especially in the presence of inflamed meninges. The good tolerability of beta-lactams makes possible high daily dose intensities, which may be associated with increased probability of cure. Furthermore, the adoption of continuous infusion seems to be a fruitful option. Fluoroquinolones, namely moxifloxacin, and antituberculosis drugs, together with the agents such as linezolid, reach the highest CSF/plasma concentration ratio, which is greater than 0.8, and for most of these drugs it is near 1. For all drugs that are currently used for the treatment of CNS infections, the evaluation of pharmacokinetic/pharmacodynamic parameters, on the basis of dosing regimens and their time-dependent or concentration-dependent pattern of bacterial killing, remains an important aspect of clinical investigation and medical practice.
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Affiliation(s)
- Antonello Di Paolo
- Division of Pharmacology, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, 56126, Pisa, Italy
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89
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MRI-Guided Focused Ultrasound as a New Method of Drug Delivery. JOURNAL OF DRUG DELIVERY 2013; 2013:616197. [PMID: 23738076 PMCID: PMC3666208 DOI: 10.1155/2013/616197] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Accepted: 02/05/2013] [Indexed: 02/01/2023]
Abstract
Ultrasound-mediated drug delivery under the guidance of an imaging modality can improve drug disposition and achieve site-specific drug delivery. The term focal drug delivery has been introduced to describe the focal targeting of drugs in tissues with the help of imaging and focused ultrasound. Focal drug delivery aims to improve the therapeutic profile of drugs by improving their specificity and their permeation in defined areas. Focused-ultrasound- (FUS-) mediated drug delivery has been applied with various molecules to improve their local distribution in tissues. FUS is applied with the aid of microbubbles to enhance the permeability of bioactive molecules across BBB and improve drug distribution in the brain. Recently, FUS has been utilised in combination with MRI-labelled liposomes that respond to temperature increase. This strategy aims to "activate" nanoparticles to release their cargo locally when triggered by hyperthermia induced by FUS. MRI-guided FUS drug delivery provides the opportunity to improve drug bioavailability locally and therefore improve the therapeutic profiles of drugs. This drug delivery strategy can be directly translated to clinic as MRg FUS is a promising clinically therapeutic approach. However, more basic research is required to understand the physiological mechanism of FUS-enhanced drug delivery.
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90
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92
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Moser D, Zadicario E, Schiff G, Jeanmonod D. Correction: MR-guided focused ultrasound technique in functional neurosurgery: targeting accuracy. J Ther Ultrasound 2013; 1:17. [PMID: 25512336 PMCID: PMC4265950 DOI: 10.1186/2050-5736-1-17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 08/30/2013] [Indexed: 11/20/2022] Open
Affiliation(s)
- David Moser
- Center of Ultrasound Functional Neurosurgery, Leopoldstrasse 1, Solothurn CH-4500, Switzerland
| | | | | | - Daniel Jeanmonod
- Center of Ultrasound Functional Neurosurgery, Leopoldstrasse 1, Solothurn CH-4500, Switzerland
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Eloy JA, Murray KP, Friedel ME, Tessema B, Liu JK. Graduated endoscopic multiangle approach for access to the infratemporal fossa: a cadaveric study with clinical correlates. Otolaryngol Head Neck Surg 2012; 147:369-78. [PMID: 22470157 DOI: 10.1177/0194599812442612] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The infratemporal fossa (ITF) has historically been one of the most difficult regions of the skull base to access surgically. Available open approaches are complex, are associated with high morbidity, and do not always afford optimal visualization. Endoscopic access to the ITF improves visualization for management of many sinonasal and lateral skull base lesions involving this region. The purpose of this study is to evaluate a graduated multiangle approach for endoscopic access to this area using a cadaveric model. STUDY DESIGN AND SETTING Cadaveric study at an academic medical center. METHODS Endoscopic dissection was performed on a total of 10 sides of 5 fresh cadaveric heads. Four different approaches to the ITF were studied: ipsilateral endonasal, endoscopically assisted Caldwell-Luc, contralateral endonasal via septotomy, and endoscopically assisted Gillies transtemporal. High-quality endoscopic pictures and high-definition videos of each technique were obtained in order to document the differences in access achieved with each approach. RESULTS The combination of the 4 different endoscopic techniques allowed complete access to all areas of the ITF. The endoscopically assisted Caldwell-Luc improved anteroposterior access, the contralateral septotomy approach resulted in excellent far lateral access, and the endoscopically assisted Gillies approach allowed posterosuperior visualization and instrumentation. CONCLUSION Endoscopic access to the ITF can be accomplished by each of the 4 methods described. A multiangle, graduated approach can provide surgeons the ability to customize surgical access depending on the location of a specific lesion within the ITF.
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Affiliation(s)
- Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey 07103, USA.
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Colen RR, Jolesz FA. MR-Guided Focused Ultrasound of the Brain. INTERVENTIONAL MAGNETIC RESONANCE IMAGING 2012. [DOI: 10.1007/174_2012_616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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